Medicare covers a portion of your healthcare provider services, and prescription drugs, but not all. You should be aware of your cost sharing. For the Part A Hospitalization benefits, after a per-benefit-instance deductible of $1635 (2024), Medicare pays 80% and you pay 20% of the remainder, leaving a large gap for more costly treatments. For the Part B Outpatient benefits, an annual deductible of $240 is due from you, as the patient. After that, Medicare will cover 80%, and you are responsible for the remaining 20%. Other coverages, like Dental, Vision, Hearing, and Long-Term Care are not covered by Medicare on a routine basis, and are out-of-pocket expenses you will incur with Original Medicare Coverage. Normally, extra coverage for Dental, Vision, Hearing and Long-Term Care must be purchased separately; Long- Term Care is never covered by Medicare at all. These “gaps” in routine health care need to be planned out in advance, as there may be a waiting period before benefits from these kinds of extra coverage will actually begin.
Filling in Coverage Gaps
Medicare health plans, like a Medicare Supplement, or a Medicare Advantage program, coupled with extra insurance, could help fill the gaps in coverage, paying even your 20% share of covered services under Medicare, or allocating your providers and services through a system of small copayments or coinsurance that is no greater than Medicare’s coverage. Plus, some programs will offer benefits and features that will cover additional services, like Dental, Vision and Hearing coverage, all included in the plan. In most cases, it’s important to make sure whatever solutions you choose include some kind of Prescription Drug Coverage.
What’s right for me?
There is no plan style that is 100% right for everyone. Instead, let’s look at what’s important to you and your care. If you can utilize the providers that you prefer, receive the care and services that you need, and affordably cover the medications that you take, and ultimately receive care in the manner and delivery that you prefer, you should be OK. To compare plans, features, benefits, and coverage, Prime Planners consultants are equipped to ask you the right questions, and show you a comprehensive selection of programs that are a custom fit for your needs. We are here for you, all-year-round!
